Pediatric anterior elbow dislocation due to a rare mechanism of injury: A case report

INTRODUCTION & IMPORTANCE: Elbow dislocations are rare among the pediatric population as their ligaments are stronger than bones. Anterior dislocations of the elbow are even rarer entity usually caused by anteriorly directed force on the hyper-flexed elbow. We present a case of a rotational force on an extended elbow causing anterior dislocation of the shoulder in an 11-year-old boy. CASE PRESENTATION: An 11-year-old boy presented to the Accident & Trauma unit with pain & swelling of the right elbow following a twisting injury by a spinning washing machine. The child was in pain. CLINICAL DISCUSSION: His elbow was semi flexed and deformed. Distal neurovascular status was found normal. Radiographs of the right elbow revealed anteromedial dislocation of the elbow with the medial epicondyle avulsion. Emergent relocation of the elbow joint has been performed. A concentric reduction, absence of incarcerated bony fragments and stability has been confirmed by the fluoroscopic examination. Post reduction neurovascular examinations unremarkable. The child was discharged with the above-elbow splint. The range of motion exercises has been commenced after three weeks. The child achieved full range of motion at six weeks of post-injury. CONCLUSION: Anterior dislocations are a rare entity in pediatric orthopaedic practice. Evaluation of the causative mechanism of injury is the clue. A rare type of mechanism of injury also should be kept in mind to prevent the delay in diagnosis and treatment.